Preoperative level of neutrophil‐lymphocyte ratio: Comparison between cyanotic and acyanotic congenital heart disease
Valdano Manuel, Leonardo Augusto Miana, Davi Jorge Fontoura Solla, Natália Fernandes, Gabriel Carrillo, Marcelo Biscegli Jatene
Abstract
Introduction Elevated neutrophil-lymphocyte ratio (NLR) has been associated with poorer outcomes in children undergoing congenital heart surgery under cardiopulmonary bypass (CPB). Objective To compare preoperative NLR levels between cyanotic and acyanotic children undergoing surgical repair with CPB. Methods We performed a retrospective cohort study in 60-paired children (30 with tetralogy of Fallot [TOF] and 30 with ventricular septal defect [VSD]) between January 2018 and December 2019 matched by age, weight, and gender. Preoperative NLR was measured from the last complete blood count test before the surgery. All of them had negative viral screening. Results The median age in VSD children was 9.5 months (interquartile range [IQR]: 5–12), weight 7 kg (IQR: 5.5–8.7), 19 (63%) was female, and NLR was 0.45 (IQR: 0.3–0.65). The median age in TOF children was 8.5 months (IQR: 5–12), weight 7.6 kg (IQR: 5.8–8.7), 16 (53%) were female, and NLR was 0.67 (IQR: 0.41–1.1). Demographic parameters did not show any statistically significant difference between groups (p > .05). Children with TOF had higher preoperative NLR compared with VSD patients (p = .004). As lower O2 saturation as higher the NLR (p = .005). Conclusion The preoperative level of NLR was higher in cyanotic congenital heart disease patients.